Heat management configurations for controlling heat dissipation from electrosurgical instruments

ABSTRACT

In various embodiments, a surgical instrument is provided that may comprise an end effector for performing a surgical procedure on tissue, for example. The end effector may comprise at least one energy delivery surface and heat dissipation means for dissipating heat from at least a portion of the end effector. For example, in at least one embodiment, the end effector may comprise a first jaw, a second jaw, and a cutting member. The cutting member may comprise a cutting surface and a body, which may define a cavity and at least one opening communicating with the cavity. A fluid may be moved through the cavity to and/or from the opening(s). Additionally, in at least one embodiment, a surgical instrument&#39;s end effector may comprise a first jaw, a second jaw, a cutting member, and at least one heat pipe. Various other heat dissipation means are also disclosed.

BACKGROUND

The present disclosure is directed to medical devices and methods, and,more particularly, to electrosurgical instruments and methods forsealing and transecting tissue.

In various circumstances, a surgical instrument can be configured toapply energy to tissue in order to treat and/or destroy the tissue. Incertain circumstances, a surgical instrument can comprise one or moreelectrodes which can be positioned against and/or positioned relative tothe tissue such that electrical current can flow from one electrode,through the tissue, and to the other electrode. The surgical instrumentcan comprise an electrical input, a supply conductor electricallycoupled with the electrodes, and/or a return conductor which can beconfigured to allow current to flow from the electrical input, throughthe supply conductor, through the electrodes and the tissue, and thenthrough the return conductor to an electrical output, for example. Invarious circumstances, heat can be generated by the current flowingthrough the tissue, wherein the heat can cause one or more hemostaticseals to form within the tissue and/or between tissues. Such embodimentsmay be particularly useful for sealing blood vessels, for example. Thesurgical instrument can also comprise a cutting member that can be movedrelative to the tissue and the electrodes in order to transect thetissue.

By way of example, energy applied by a surgical instrument may be in theform of radio frequency (“RF”) energy. RF energy is a form of electricalenergy that may be in the frequency range of 300 kilohertz (kHz) to 1megahertz (MHz). In application, RF surgical instruments transmit lowfrequency radio waves through electrodes, which cause ionic agitation,or friction, increasing the temperature of the tissue. Since a sharpboundary is created between the affected tissue and that surrounding it,surgeons can operate with a high level of precision and control, withoutmuch sacrifice to the adjacent normal tissue. The low operatingtemperatures of RF energy enables surgeons to remove, shrink or sculptsoft tissue while simultaneously sealing blood vessels. RF energy worksparticularly well on connective tissue, which is primarily comprised ofcollagen and shrinks when contacted by heat.

Further, in various open and laparoscopic surgeries, it may be necessaryto coagulate, seal or fuse tissues. One means of sealing tissue reliesupon the application of electrical energy to tissue captured within anend effector of a surgical instrument in order to cause thermal effectswithin the tissue. Various mono-polar and bi-polar RF jaw structureshave been developed for such purposes. In general, the delivery of RFenergy to the captured tissue elevates the temperature of the tissueand, as a result, the energy can at least partially denature proteinswithin the tissue. Such proteins, such as collagen, for example, may bedenatured into a proteinaceous amalgam that intermixes and fuses, or“welds,” together as the proteins renature. As the treated region healsover time, this biological “weld” may be reabsorbed by the body's woundhealing process.

In certain arrangements of a bi-polar radiofrequency (RF) jaw, thesurgical instrument can comprise opposing first and second jaws, whereinthe face of each jaw can comprise an electrode. In use, the tissue canbe captured between the jaw faces such that electrical current can flowbetween the electrodes in the opposing jaws and through the tissuepositioned therebetween. Such instruments may have to seal or “weld”many types of tissues, such as anatomic structures having walls withirregular or thick fibrous content, bundles of disparate anatomicstructures, substantially thick anatomic structures, and/or tissues withthick fascia layers such as large diameter blood vessels, for example.With particular regard to sealing large diameter blood vessels, forexample, such applications may require a high strength tissue weldimmediately post-treatment.

The foregoing discussion is intended only to illustrate the presentfield and should not be taken as a disavowal of claim scope.

SUMMARY

In various embodiments, a surgical instrument is provided. In at leastone embodiment, the surgical instrument can comprise an end effectorcomprising a first jaw, a second jaw, and a cutting member. In theseembodiments, the first jaw and the second jaw can be operably coupledtogether. Additionally, in these embodiments, the cutting member can beconfigured to translate with respect to the first jaw. Further, in theseembodiments, the cutting member can comprise a cutting surface and abody. Moreover, in these embodiments, the body can define a cavity andat least one opening communicating with the cavity.

In at least one embodiment, a surgical instrument is provided that cancomprise an end effector comprising a first jaw, a second jaw, a cuttingmember, and at least one heat pipe. In these embodiments, the first jawcan comprise an energy delivery surface and define a channel.Additionally, in these embodiments, the first jaw and the second jaw canbe operably coupled together. Further, the cutting member can beconfigured to translate with respect to the first jaw.

In at least one embodiment, a surgical instrument is provided that cancomprise an end effector. In these embodiments, the end effector cancomprise at least one energy delivery surface and heat dissipation meansfor dissipating heat from at least a portion of the end effector.

The foregoing discussion should not be taken as a disavowal of claimscope.

FIGURES

Various features of the embodiments described herein are set forth withparticularity in the appended claims. The various embodiments, however,both as to organization and methods of operation, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows.

FIG. 1 is a perspective view of a surgical instrument according to anon-limiting embodiment.

FIG. 2 is a side view of a handle of the surgical instrument of FIG. 1with a half of a handle body removed to illustrate some of thecomponents therein.

FIG. 3 is a perspective view of an end effector of the surgicalinstrument of FIG. 1 illustrated in an open configuration; the distalend of a cutting member is illustrated in a retracted position.

FIG. 4 is a perspective view of the end effector of the surgicalinstrument of FIG. 1 illustrated in a closed configuration; the distalend of the cutting member is illustrated in a partially advancedposition.

FIG. 5 is a perspective view of a portion of a cutting member of thesurgical instrument of FIG. 1; the cutting member is shown at leastpartially shaped like an I-beam.

FIG. 6A is a perspective sectional view of a portion of the cuttingmember of the surgical instrument of FIG. 1, taken along line 6A-6A inFIG. 5.

FIG. 6B is a cross-sectional view of the cutting member of the surgicalinstrument of FIG. 1, taken along line 6B-6B in FIG. 5.

FIG. 7 is a perspective view of a portion of a cutting member of asurgical instrument according to a non-limiting embodiment.

FIG. 8A is a cross-sectional view of the cutting member of FIG. 7 takenalong line 8A-8A.

FIG. 8B is a cross-sectional view of a portion of a cutting member of asurgical instrument according to a non-limiting embodiment.

FIG. 8C is a cross-sectional view of a portion of a cutting member of asurgical instrument according to a non-limiting embodiment.

FIG. 8D is a cross-sectional view of a portion of a cutting member of asurgical instrument according to a non-limiting embodiment.

FIG. 9 is a perspective view of a portion of a cutting member of asurgical instrument according to a non-limiting embodiment.

FIG. 10 is a cross-sectional view of the cutting member of FIG. 9, takenalong line 10-10.

FIG. 11 is a perspective, partial-sectional view of a portion of an endeffector of a surgical instrument according to a non-limitingembodiment.

FIG. 12A is a partial cross-sectional view of a portion of a cuttingmember of the surgical instrument of FIG. 11, taken along line 12A-12A.

FIG. 12B is a partial cross-sectional view of a portion of a cuttingmember of the surgical instrument of FIG. 11, taken along line 12B-12B.

FIG. 13 is a side view of a surgical instrument according to anon-limiting embodiment; half of a handle body of the surgicalinstrument is removed to illustrate some of the components therein andsome of the instrument's components are omitted for clarity.

FIG. 14 is a side view of a handle of a surgical instrument according toa non-limiting embodiment; a portion of a handle body of the surgicalinstrument is cut away to illustrate some of the components therein.

FIG. 15 is a perspective, partial-sectional view of a portion of an endeffector of a surgical instrument according to a non-limitingembodiment.

FIG. 16 is a perspective sectional view of a portion of the end effectorof FIG. 15.

FIG. 17 is a perspective sectional view of a portion of an end effectorof a surgical instrument according to a non-limiting embodiment.

FIG. 18 is a perspective sectional view of a portion of an end effectorof a surgical instrument according to a non-limiting embodiment.

FIG. 19 is a cross-sectional view of an end effector of a surgicalinstrument according to a non-limiting embodiment.

FIG. 20 is a perspective sectional view of a portion of a Peltier deviceof the end effector of FIG. 19.

FIG. 21 is a perspective sectional view of a portion of a jaw of the endeffector of FIG. 19.

FIG. 22 is a cross-sectional view of an end effector of a surgicalinstrument according to a non-limiting embodiment.

FIG. 23 is a perspective view of a portion of the end effector of FIG.22.

FIG. 24 is a side view of an end effector of a surgical instrumentaccording to a non-limiting embodiment; the end effector is shown in anopen configuration.

FIG. 25 is a cross-section view of the end effector of FIG. 24; the endeffector is shown in a closed configuration.

FIG. 26 is a perspective sectional view of a portion of a heat pipe ofthe surgical instrument of FIG. 24.

FIG. 27 is a perspective, partial-sectional view of various componentsof a surgical instrument according to a non-limiting embodiment.

FIG. 28 is a side cross-sectional view of a portion of the surgicalinstrument of FIG. 27, taken along line 28-28; jaws of the surgicalinstrument are omitted for clarity.

FIG. 29 is a side view of a handle of a surgical instrument according toa non-limiting embodiment; half of a handle body of the surgicalinstrument is removed to illustrate some of the components therein.

FIG. 30 is a side view of a handle of a surgical instrument according toa non-limiting embodiment; half of a handle body of the surgicalinstrument is removed to illustrate some of the components therein.

FIG. 31 is a schematic view of a vortex tube of the surgical instrumentof FIG. 30.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments, in one or more forms, and suchexemplifications are not to be construed as limiting the scope of theclaims in any manner.

DETAILED DESCRIPTION

Various embodiments are directed to apparatuses, systems, and methodsfor the treatment of tissue. Numerous specific details are set forth toprovide a thorough understanding of the overall structure, function,manufacture, and use of the embodiments as described in thespecification and illustrated in the accompanying drawings. It will beunderstood by those skilled in the art, however, that the embodimentsmay be practiced without such specific details. In other instances,well-known operations, components, and elements have not been describedin detail so as not to obscure the embodiments described in thespecification. Those of ordinary skill in the art will understand thatthe embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative and do notnecessarily limit the scope of the embodiments, the scope of which isdefined solely by the appended claims.

Reference throughout the specification to “various embodiments,” “someembodiments,” “one embodiment,” or “an embodiment”, or the like, meansthat a particular feature, structure, or characteristic described inconnection with the embodiment is included in at least one embodiment.Thus, appearances of the phrases “in various embodiments,” “in someembodiments,” “in one embodiment,” or “in an embodiment”, or the like,in places throughout the specification are not necessarily all referringto the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments. Thus, the particular features, structures, orcharacteristics illustrated or described in connection with oneembodiment may be combined, in whole or in part, with the featuresstructures, or characteristics of one or more other embodiments withoutlimitation.

It will be appreciated that the terms “proximal” and “distal” may beused throughout the specification with reference to a clinicianmanipulating one end of an instrument used to treat a patient. The term“proximal” refers to the portion of the instrument closest to theclinician and the term “distal” refers to the portion located farthestfrom the clinician. It will be further appreciated that for concisenessand clarity, spatial terms such as “vertical,” “horizontal,” “up,” and“down” may be used herein with respect to the illustrated embodiments.However, surgical instruments may be used in many orientations andpositions, and these terms are not intended to be limiting and absolute.

The entire disclosures of the following non-provisional United Statespatents are hereby incorporated by reference herein:

U.S. Pat. No. 7,381,209, entitled ELECTROSURGICAL INSTRUMENT;

U.S. Pat. No. 7,354,440, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE;

U.S. Pat. No. 7,311,709, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE;

U.S. Pat. No. 7,309,849, entitled POLYMER COMPOSITIONS EXHIBITING A PTCPROPERTY AND METHODS OF FABRICATION;

U.S. Pat. No. 7,220,951, entitled SURGICAL SEALING SURFACES AND METHODSOF USE;

U.S. Pat. No. 7,189,233, entitled ELECTROSURGICAL INSTRUMENT;

U.S. Pat. No. 7,186,253, entitled ELECTROSURGICAL JAW STRUCTURE FORCONTROLLED ENERGY DELIVERY;

U.S. Pat. No. 7,169,146, entitled ELECTROSURGICAL PROBE AND METHOD OFUSE;

U.S. Pat. No. 7,125,409, entitled ELECTROSURGICAL WORKING END FORCONTROLLED ENERGY DELIVERY; and

U.S. Pat. No. 7,112,201, entitled ELECTROSURGICAL INSTRUMENT AND METHODOF USE.

The following United States patent applications, filed on even dateherewith, Jun. 10, 2010, are also hereby incorporated by referenceherein:

U.S. patent application Ser. No 12/797,844,entitled ELECTROSURGICALINSTRUMENT COMPRISING SEQUENTIALLY ACTIVATED ELECTRODES, now U.S. PatentPublication No. 2011/0306973;

U.S. patent application Ser. No. 12/797,853,entitled ELECTROSURGICALINSTRUMENT EMPLOYING A THERMAL MANAGEMENT SYSTEM, now U.S. PatentPublication No. 2011/0306972; and

U.S. patent application Ser. No. 12/797,861, entitled COOLINGCONFIGURATIONS FOR ELECTROSURGICAL INSTRUMENTS, now U.S. PatentPublication No. 2011/0306967.

Various embodiments of systems and methods relate to creating thermal“welds” or “fusion” within native tissue volumes. The alternative termsof tissue “welding” and tissue “fusion” may be used interchangeablyherein to describe thermal treatments of a targeted tissue volume thatresult in a substantially uniform fused-together tissue mass, forexample, in welding blood vessels that exhibit substantial burststrength immediately post-treatment. The strength of such welds isparticularly useful for (i) permanently sealing blood vessels in vesseltransection procedures; (ii) welding organ margins in resectionprocedures; (iii) welding other anatomic ducts wherein permanent closureis required; and also (iv) for performing vessel anastomosis, vesselclosure or other procedures that join together anatomic structures orportions thereof. The welding or fusion of tissue as disclosed herein isto be distinguished from “coagulation”, “hemostasis” and other similardescriptive terms that generally relate to the collapse and occlusion ofblood flow within small blood vessels or vascularized tissue. Forexample, any surface application of thermal energy can cause coagulationor hemostasis—but does not fall into the category of “welding” as theterm is used herein. Such surface coagulation does not create a weldthat provides any substantial strength in the treated tissue.

At the molecular level, the phenomena of truly “welding” tissue asdisclosed herein may result from the thermally-induced denaturation ofcollagen and other protein molecules in a targeted tissue volume tocreate a transient liquid or gel-like proteinaceous amalgam. A selectedenergy density is provided in the targeted tissue to cause hydrothermalbreakdown of intra- and intermolecular hydrogen crosslinks in collagenand other proteins. The denatured amalgam is maintained at a selectedlevel of hydration—without desiccation—for a selected time intervalwhich can be very brief. The targeted tissue volume is maintained undera selected very high level of mechanical compression to insure that theunwound strands of the denatured proteins are in close proximity toallow their intertwining and entanglement. Upon thermal relaxation, theintermixed amalgam results in protein entanglement as re-crosslinking orrenaturation occurs to thereby cause a uniform fused-together mass.

A surgical instrument can be configured to supply energy, such aselectrical energy, ultrasonic energy, and/or heat energy, for example,to the tissue of a patient. For example, various embodiments disclosedherein provide electrosurgical jaw structures adapted for transectingcaptured tissue between the jaws and for contemporaneously welding orsealing the captured tissue margins with controlled application of RFenergy. In more detail, in various embodiments, referring now to FIG. 1,an electrosurgical instrument 100 is shown. Surgical or electrosurgicalinstrument 100 can comprise a proximal handle 105, a distal working endor end effector 110 and an introducer or elongate shaft 108 disposedin-between. End effector 110 may comprise a set of openable-closeablejaws with straight or curved jaws—an upper first jaw 120A and a lowersecond jaw 120B. First jaw 120A and second jaw 120B may each comprise anelongate slot or channel 142A and 142B (see FIG. 3), respectively,disposed outwardly along their respective middle portions. First jaw120A and second jaw 120B may be coupled to an electrical source 145 anda controller 150 through electrical leads in cable 152. Controller 150may be used to activate electrical source 145. In various embodiments,the electrical source 145 may comprise an RF source, an ultrasonicsource, a direct current source, and/or any other suitable type ofelectrical energy source, for example.

Moving now to FIG. 2, a side view of the handle 105 is shown with halfof a first handle body 106A (see FIG. 1) removed to illustrate some ofthe components within second handle body 106B. Handle 105 may comprise alever arm 128 which may be pulled along a path 129. Lever arm 128 may becoupled to a movable cutting member 140 disposed within elongate shaft108 by a shuttle 146 operably engaged to an extension 127 of lever arm128. The shuttle 146 may further be connected to a biasing device, suchas spring 141, which may also be connected to the second handle body106B, to bias the shuttle 146 and thus the cutting member 140 in aproximal direction, thereby urging the jaws 120A and 120B to an openposition as seen in FIG. 1. Also, referring to FIGS. 1 and 2, a lockingmember 131 (see FIG. 2) may be moved by a locking switch 130 (seeFIG. 1) between a locked position, where the shuttle 146 issubstantially prevented from moving distally as illustrated, and anunlocked position, where the shuttle 146 may be allowed to freely movein the distal direction, toward the elongate shaft 108. The handle 105can be any type of pistol-grip or other type of handle known in the artthat is configured to carry actuator levers, triggers or sliders foractuating the first jaw 120A and second jaw 120B. Elongate shaft 108 mayhave a cylindrical or rectangular cross-section and can comprise athin-wall tubular sleeve that extends from handle 105. Elongate shaft108 may include a bore extending therethrough for carrying actuatormechanisms, for example, cutting member 140, for actuating the jaws andfor carrying electrical leads for delivery of electrical energy toelectrosurgical components of end effector 110.

End effector 110 may be adapted for capturing, welding or sealing, andtransecting tissue. First jaw 120A and second jaw 120B may close tothereby capture or engage tissue about a longitudinal axis 125 definedby cutting member 140. First jaw 120A and second jaw 120B may also applycompression to the tissue. Elongate shaft 108, along with first jaw 120Aand second jaw 120B, can be rotated a full 360° degrees, as shown byarrow 117, relative to handle 105 through, for example, a rotary triplecontact. First jaw 120A and second jaw 120B can remain openable and/orcloseable while rotated.

FIGS. 3 and 4 illustrate perspective views of end effector 110. FIG. 3shows end effector 110 in an open configuration and FIG. 4 shows endeffector 110 in a closed configuration. As noted above, the end effector110 may comprise the upper first jaw 120A and the lower second jaw 120B.Further, the first jaw 120A and second jaw 120B may each havetissue-gripping elements, such as teeth 143, disposed on the innerportions of first jaw 120A and second jaw 120B. First jaw 120A maycomprise an upper first jaw body 161A with an upper first outward-facingsurface 162A and an upper first energy delivery surface 175A of a firstelectrode, for example. Second jaw 120B may comprise a lower second jawbody 161B with a lower second outward-facing surface 162B and a lowersecond energy delivery surface 175B of a second electrode, for example.First energy delivery surface 175A and second energy delivery surface175B may both extend in a “U” shape about the distal end of end effector110. Additionally, in at least one embodiment, one or both electrodesmay each comprise a segmented electrode or electrodes as described inU.S. patent application Ser. No. 12/797,844,entitled ELECTROSURGICALINSTRUMENT COMPRISING SEQUENTIALLY ACTIVATED ELECTRODE, now U.S. PatentPublication No. 2011/0305973, filed on even date herewith, Jun. 10,2010, and incorporated by reference herein.

Referring briefly now to FIGS. 5-6A, a portion of cutting member 140 isshown. The lever arm 128 of handle 105, see FIG. 2, may be adapted toactuate cutting member 140 which also functions as a jaw-closingmechanism. For example, cutting member 140 may be urged distally aslever arm 128 is pulled proximally along path 129 via shuttle 146, seenin FIG. 2 and discussed above. The cutting member 140 may comprise oneor several pieces, but in any event, may be movable or translatable withrespect to the elongate shaft 108 and/or jaws 120A, 120B. Also, in atleast one embodiment, the cutting member 140 may be made of 17-4precipitation hardened stainless steel. The distal end of cutting member140 may comprise a flanged “I”-beam configured to slide within channels142A and 142B in jaws 120A and 120B. Cutting member 140 may slide withinchannels 142A, 142B to open and close first jaw 120A and second jaw120B. The distal end of cutting member 140 may also comprise upperflange or “c”-shaped portion 140A and lower flange or “c”-shaped portion140B. The flanges 140A and 140B respectively define inner cam surfaces144A and 144B for engaging outward facing surfaces of first jaw 120A andsecond jaw 120B. The opening-closing of jaws 120A and 120B can applyvery high compressive forces on tissue using cam mechanisms which mayinclude reciprocating “I-beam” cutting member 140 and the outward facingsurfaces 162A, 162B of jaws 120A, 120B.

More specifically, referring now to FIGS. 3-5, collectively, inner camsurfaces 144A and 144B of the distal end of cutting member 140 may beadapted to slidably engage first outward-facing surface 162A and secondoutward-facing surface 162B of first jaw 120A and second jaw 120B,respectively. Channel 142A within first jaw 120A and channel 142B withinsecond jaw 120B may be sized and configured to accommodate the movementof cutting member 140, which may comprise a tissue-cutting element, forexample, a sharp distal edge and/or surface 153 (see FIG. 5). FIG. 4,for example, shows the distal end of cutting member 140 advanced atleast partially through channels 142A and 142B (see FIG. 3). Theadvancement of cutting member 140 can close end effector 110 from theopen configuration shown in FIG. 3. The cutting member 140 may move ortranslate along the channel 142A between a retracted position and afully advanced position. The retracted position can be seen in FIG. 3,where the jaws 120A, 120B are in an open position and a distal end 151of the cutting member 140 is positioned proximal to the upperoutward-facing surface 162A. The fully advanced position, while notshown, may occur when the distal end 151 of the cutting member 140 isadvanced to a distal end 164 of channel 142A and the jaws are in aclosed position, see FIG. 4. In the closed position shown by FIG. 4,upper first jaw 120A and lower second jaw 120B define a gap or dimensionD between the first energy delivery surface 175A and second energydelivery surface 175B of first jaw 120A and second jaw 120B,respectively. Dimension D equals from about 0.0005″ to about 0.005″ andpreferably between about 0.001″ to about 0.002″. Also, the edges offirst energy delivery surface 175A and second energy delivery surface175B may be rounded to prevent the dissection of tissue.

Referring now to FIGS. 1 and 3, end effector 110 may be coupled toelectrical source 145 and controller 150. First energy delivery surface175A and second energy delivery surface 175B may likewise each becoupled to electrical source 145 and controller 150. First energydelivery surface 175A and second energy delivery surface 175B may beconfigured to contact tissue and delivery electrosurgical energy toengaged tissue which is adapted to seal or weld the tissue. Controller150 can regulate the electrical energy delivered by electrical source145 which in turn delivers electrosurgical energy to firstenergy-delivery surface 175A and second energy-delivery surface 175B.The energy delivery may be initiated by an activation button 124operably engaged with lever arm 128 and in electrical communication withcontroller 150 via cable 152. As mentioned above, the electrosurgicalenergy delivered by electrical source 145 may comprise radiofrequency(RF) energy. Further, the opposing first and second energy deliverysurfaces 175A and 175B may carry variable resistive positive temperaturecoefficient (PTC) bodies that are coupled to electrical source 145 andcontroller 150. Additional details regarding electrosurgical endeffectors, jaw closing mechanisms, and electrosurgical energy-deliverysurfaces are described in the following U.S. patents and publishedpatent applications, all of which are incorporated herein in theirentirety by reference and made a part of this specification: U.S. Pat.Nos. 7,381,209; 7,311,709; 7,220,951; 7,189,233; 7,186,253; 7,125,409;7,112,201; 7,087,054; 7,083,619; 7,070,597; 7,041,102; 7,011,657;6,929,644; 6,926,716; 6,913,579; 6,905,497; 6,802,843; 6,770,072;6,656,177; 6,533,784; and 6,500,176; and U.S. Pat. App. Pub. Nos.2010/0036370 and 2009/0076506.

In various embodiments, it may be desirable to dissipate heat from anend effector such that when energy is delivered to the end effector, asdescribed above with respect to end effector 110, for instance, thelikelihood that tissue contacting the end effector will beunintentionally thermally altered by the end effector may be reduced oreliminated. Additionally, dissipating heat from the end effector canlead to cooling the sealed area of tissue more quickly which may producestronger tissue welds. Further, cooling the tissue and/or at least aportion of the end effector after welding the tissue, as discussedabove, may minimize the amount of thermal energy spread into and/orthrough tissue adjacent to the desired seal area. Accordingly, in atleast one embodiment and referring again to FIG. 1, a surgicalinstrument, such as surgical instrument 100 described above, may beconfigured to dissipate heat from an end effector by extracting heat ordepositing a cooling medium to the target tissue and/or end effector.The surgical instrument 100 may comprise an end effector 110 that mayalso include at least one energy delivery surface, such as first and/orsecond energy delivery surfaces 175A and 175B (see FIG. 3).Additionally, in various embodiments, referring to FIG. 2, the surgicalinstrument 100 may comprise a pump, such as pump 180, for example, thatis configured to cause a fluid to move into at least a portion of theend effector 110. More specifically, in at least one exemplaryembodiment, referring now to FIGS.1-2, a surgical instrument 100 may beprovided that comprises a pump 180 operably coupled to a handle 105.FIG. 2 shows the first handle body removed to show the components ofsurgical instrument 100 associated with and/or within handle 105. Asillustrated, the pump 180 may be coupled to part of the handle body,such as second handle body 106B. However, while pump 180 is shownlocated within handle 105, the pump 180 may alternatively be positionedexternal to the handle 105. In any event, the pump 180 may be configuredto cause a fluid to move through the cutting member 140 and into atleast a portion of the end effector 110. In at least one embodiment, thefluid may be a gas, such as air, for example. Alternatively, asdiscussed below, the fluid may be a liquid, such as water, distilledwater, and/or saline solution, for example.

In more detail, referring still to FIGS. 1-2, the handle 105 mayadditionally comprise a fluid port 181 located on the body. The fluidport 181 may comprise a vent, for example, through which air fromoutside the instrument may pass. Additionally, in at least oneembodiment, the fluid port 181 may comprise a filter, such as a HEPA airfilter, to purify the air passing therethrough. The pump 180 maycomprise an inlet 180A and an outlet 180B for the fluid to enter andexit the pump 180, respectively. In at least one embodiment, the inlet180A may be coupled to the fluid port 181 via first tubing 182 and theoutlet 180B may be coupled to the cutting member 140 by second tubing183 at a proximal hole 149 of the cutting member 140.

In at least one embodiment, referring to FIG. 5, the cutting member 140may comprise a body 155 and a cutting surface 153 that may be located ata distal portion of the cutting member 140. Referring now also to FIGS.6A and 6B, the body 155 may define a cavity 147 therein and at least oneopening, such as openings 148, for example. As shown, the cavity 147 maylie along the longitudinal axis 125 of the cutting member.Alternatively, although not shown in FIGS. 6A-6B, the cavity may beoffset from the longitudinal axis 125. Additionally, as illustrated,there may be at least two or more openings 148. As can be seen in FIG.6B, one or more of the openings 148 may communicate with the cavity 147such that a fluid, may pass therethrough. In at least one embodiment,the openings 148 may be positioned proximal to the cutting surface 153.In other words, in various embodiments, taking the instrument 100 as awhole, the cutting member opening or openings 148 may be positionedbetween the handle 105 (FIG. 1) and the cutting surface 153 (FIG. 5).Further, in at least one embodiment, the opening or openings 148 may bepositioned near the cutting surface 153 such that the openings 148 areconfigured to dissipate heat from tissue immediately after the tissue iscut by cutting surface 153. Additionally, although not illustrated, theproximal hole 149 in cutting member 140 may communicate with the cavity147 such that fluid flowing from second tubing 183 and into the cuttingmember 140 may pass through the cavity 147 and out openings 148 toeffectuate heat dissipation from the cut tissue and/or end effector 110.Accordingly, the cavity 147 may partially reside within the handle 105to a distal end of the elongate shaft 108 and/or into end effector 110.

In use, the surgical instrument 100, may function as follows. In atleast one embodiment, referring to FIGS. 1-2, when activation button 124is pressed to supply energy to the end effector 110, as discussed above,the pump 180 may simultaneously or shortly thereafter activate. In suchembodiments, the pump 180 may be connected to the activation button 124by at least one electrical conductor (not shown), such as an electricallead, insulated wire, and/or copper wire, for example. Accordingly, thebutton 124 may be configured to be moved between a first and a secondposition where the second position completes an electrical circuit suchthat current may flow from a power source outside the instrument, suchas that associated with controller 150 and/or electrical source 145, forexample, to the pump 180. Thus, in at least one embodiment, when thebutton 124 is depressed to the second position, electrical current mayflow from the electrical source 145, for example, through the electricalconductors (not shown), to the pump 180. The pump 180 may therebyactivate and begin to draw air, designated by arrows 184, into fluidport 181, through first tubing 182 and into pump 180 via inlet 180A. Thepump 180 may continue to force the air, designated by arrow 185, outoutlet 180B, into second tubing 183 and into the cutting member 140 viaproximal hole 149. The air, designated by arrows 186, may then travel ina distal direction through the cavity 147 of the cutting member 140,through the elongate shaft 108, and toward the end effector 110. The airmay thereafter be forced into at least a portion of the end effector110. In at least one embodiment, the air may enter the space betweenjaws 120A and 120B, thereby allowing for the energy delivery surfaces175A and 175B and any tissue between the jaws 120A and 120B to besubsequently cooled.

While the pump 180 may be configured to operate during a surgicalprocedure by being activated at or at about the same time as energy isdelivered to surfaces 175A and/or 175B, the pump 180 may be configuredto be selectively activated independently of the energy deliveryactivation button's use. Referring to FIG. 2, in at least oneembodiment, the pump may alternatively be coupled to a control button(not shown) on the exterior of the handle 105. In such embodiments, thepump 180 may be activated before, during, and/or after a surgicalprocedure by pressing the control button, thereby allowing for selectivecooling of the end effector 110 (see FIG. 1) before, during, and/orafter a surgical operation. Alternatively, the pump may be activated bythe controller 150 during a predetermined time within the treatmentcycle, for example.

As discussed above, a surgical instrument may comprise a pump that isconfigured to cause a fluid to move over at least a portion of an endeffector as described above, for example, by forcing or pushing a fluid,such as a gas, like air, for example, in a distal direction into atleast a portion of the end effector. Alternatively, in variousembodiments, a surgical instrument may comprise a pump that isconfigured to force or draw a fluid in a proximal direction over part ofthe end effector. In other words, a pump may be configured to functionlike a vacuum and draw one or more fluids into the end effector, forexample. Accordingly, in at least one embodiment, referring to FIGS. 1,2, and 5-6B, the pump 180 described above may be reversed such that,when the pump is activated, it functions as a vacuum. In suchembodiments, air, carbon dioxide, or steam, for example, may be drawninto cutting member openings 148, through the cutting member cavity 147,out proximal hole 149, into pump 180, and then out fluid port 181, whichmay serve an exhaust vent. Accordingly, heated substances, such as air,carbon dioxide, and steam, for example, may be drawn from the endeffector 110 and/or target tissue to remove the heated substance(s)therefrom, thereby cooling or dissipating heat from the end effector 110and/or target tissue.

In various embodiments, different configurations of the cutting member140, cavity 147, and/or opening(s) 148 may be employed to dissipate heatfrom the end effector 110 and/or target tissue. For example, as seen inFIGS. 5 and 6B, the cutting member 140 may define a longitudinal axis125 and the opening(s) 148 may define a plane that is parallel to thelongitudinal axis 125. In other words, the openings 148 may project tothe sides of the cutting member 140. However, the opening or openings ofa cutting member may be oriented differently. For example, referring nowto FIGS. 7 and 8A, in at least one embodiment, a cutting member 240,similar in some respects to cutting member 140, may comprise a cuttingsurface 253 and a body including a distal body portion 255B (discussedin more detail below) and a proximal body portion 255A. The cuttingsurface 253 may be a part of and/or positioned on distal body portion255B. The proximal body portion 255A may define a cavity 247 andopenings 248 may communicate with the cavity 247. Further, the cuttingmember 240 may define a longitudinal axis 225 and the opening oropenings 248 may define a plane that intersects the longitudinal axis225. In other words, the openings may project proximally or distallywith respect to the cutting surface 253 of the cutting member 240. Asillustrated in FIGS. 7 and 8A, the openings 248 project distally,towards the cutting surface 253. Further, arrows 287 illustrate apotential fluid flow path for a fluid flowing through the cuttingmember's cavity 247 and out openings 248, for example.

Additional heat may be dissipated from the end effector 110 (FIG. 1)and/or the target tissue by using a cutting member, such as cuttingmember 240, for example, that comprises two materials. For example,referring to FIG. 7, the cutting member's proximal body portion 255A maybe made from a plastic, whereas the cutting member's distal body portion255B may be made from a metal, such as steel, for example. In at leastone embodiment, the distal body portion 255B may be coupled to theproximal body portion 255A at one or more tongue-in-groove connections256. In such embodiments, owing to the material disparity and theinability of plastic to efficiently conduct heat, any heated substancepassed through the cutting member's proximal body portion 255A may notconduct heat as effectively as the distal portion 255B, therebypreventing or resisting components of the surgical instrument 100 (FIG.1), including end effector 110 and shaft 108, for example, from heatingup when a heat substance is passed through the cutting member 240. Suchembodiments may be particularly useful when the pump 180 (FIG. 2) isused as a vacuum to draw heated air and/or steam through the cuttingmember 240, for example.

Additional exemplary configurations of a cutting member, similar in somerespects to cutting member 140 described above, are shown in FIGS.8B-8D. FIGS. 8B, 8C, and 8D illustrate cutting members 240′, 240″, and240′″, respectively, and are taken along a similar cross-section line asline 8A-8A seen in FIG. 7 for cutting member 240. Referring now to FIG.8B, in at least one embodiment, the cutting member 240′ may comprise acutting surface 253′ and a body including a distal body portion 255B′and a proximal body portion 255A′. The cutting surface 253′ may be apart of and/or positioned on the distal body portion 255B′. The proximalbody portion 255A′ may define a cavity (not shown) and openings 248′communicating with the cavity. While not illustrated, the cavity may lieout of the plane define by the page of FIG. 8B and/or the longitudinalaxis 225′, for example. Additionally, each opening 248′ may traverse theentire width of the cutting member's proximal body portion 255A′,running from one side of the body portion 255A′ to the other side. Thecutting member 240′ may also define a longitudinal axis 225′ and theopening(s) 248′ may define a plane that is parallel to the longitudinalaxis 225′. In other words, the openings 248′ may project to the sides ofthe cutting member 240′.

Focusing now on FIG. 8C, in at least one embodiment, the cutting member240″ may comprise a body 255″ and a cutting surface 253″ at a distalportion of the body 255″. The body 255″ may define a cavity 247″ andopenings 248″ communicating with the cavity. Additionally, each opening248″ may traverse a side wall of the cutting member's body 255″, runningfrom a side of the body 255″ to the cavity 247″. The cutting member 240″may also define a longitudinal axis 225″ and the opening(s) 248″ maydefine a plane that is parallel to the longitudinal axis 225″. In otherwords, the openings 248″ may project to the sides of the cutting member240″. Further, arrows 287″ illustrate a potential fluid flow path for afluid flowing through the cutting member's cavity 247″ and out openings248″, for example. Also, while not illustrated, cavity 247″ may beoffset from longitudinal axis 225″.

Referring to FIG. 8D, in at least one embodiment, the cutting member240′″ may comprise a cutting surface 253′″ and a body including a distalbody portion 255B′″ and a proximal body portion 255A′″. The cuttingsurface 253′″ may be a part of and/or positioned on distal body portion255B′″. The proximal body portion 255A′″ may define a cavity 247′″ andopenings 248′″ communicating with the cavity 247′″. Further, the cuttingmember 240′″ may define a longitudinal axis 225′″ and the opening oropenings 248′″ may define a plane that intersects the longitudinal axis225′″. In other words, the openings may project proximally or distallywith respect to the cutting surface 253′″ of the cutting member 240′″.As illustrated in FIG. 8D, the openings 248′″ project distally, towardsthe cutting surface 253′″. Further, arrows 287′″ illustrate a potentialfluid flow path for a fluid flowing through the cutting member's cavity247′″ and out openings 248′″, for example.

Additionally, as discussed above, a cutting member, such as cuttingmember 240′″, for example, may be configured to translate with respectto the first jaw 120A and/or second jaw 120B (see FIG. 4). In suchembodiments, as discussed above with respect to cutting member 140, thecutting member 240′″ may be moved between a retracted position and afully advanced position with respect to the first and/or second jaws120A and/or 120B. However, unlike cutting member 140, the openings 248′″of cutting member 240′″ may be positioned such that that the openings248′″ are positioned proximal to one or both of energy delivery surfaces175A and 175B when the cutting member 240′″ is at the fully advancedposition. In other words, the opening(s) 248′″ may be positioned betweenthe first jaw 120A and the handle 105 (FIGS. 1 and 2) when the cuttingmember is at the fully advanced position. In such embodiments, thecutting member openings 248′″ may not enter the space where tissue isbeing clamped, cut, and/or sealed, even when the cutting member 240′″ isfully advanced. Further, referring to FIG. 4, the first jaw's channel142A may define a first length, L1. Referring to FIG. 8D, the cuttingmember 240′″ may define a second length, L2, as measured from one of theopenings 248′″ to a distal edge of the cutting surface 253′″. In theseembodiments, the first length may be approximately equal to the secondlength, or L1≈L2.

FIGS. 9-10 illustrate another exemplary embodiment of a cutting member340, generally similar to cutting member 140 described above. Forexample, among other things, the cutting member 340 may comprise a body355 and a cutting surface 353 at a distal portion of the body 355. Thebody 355 may define a cavity 347 and openings 348 communicating with thecavity 347. Additionally, each opening 348 may traverse a side wall ofthe cutting member's body 355, running from a side of the body 355 tothe cavity 347. Additionally, the cavity 347 may comprise a largerportion 347A and a smaller portion 347B in fluid communication with eachother. The smaller portion 347B may also directly communicate with theopenings 348. Accordingly, the pressure of fluid flowing in or out ofopenings 348, from or through smaller cavity portion 347B may beincreased over that provided to larger cavity portion 347A.

FIGS. 11-12B illustrate another exemplary embodiment of a cutting member440, generally similar to cutting member 140 described above. As seen inFIG. 11, the cutting member 440 may be a part of an end effector 410,also similar to end effector 110 described above. In any event, amongother things, the cutting member 440 may comprise a body 455 and acutting surface 453 at a distal portion of the body 455. The body 455may define a cavity 447 and at least one opening 448 communicating withthe cavity 447. The opening 448 may be proximal to the cutting surface453. Additionally, each opening 448 may traverse a side wall of thecutting member's body 455, running from a side of the body 455 to thecavity 447. Moreover, a porous material or insert 460 may be positionedwithin the opening 448. The porous insert 460 may comprise a cellularmatrix and/or a sponge-like material. In any event, the porous insertmay comprise one or more pores 463. The porous insert 460 and/or pores463 may help direct any fluid passing therethrough in differentdirections as shown by the arrows in FIG. 12B.

Various mechanisms may be employed to move fluid through a cuttingmember in a surgical instrument. For example, referring now to FIG. 13,a surgical instrument 500 is shown coupled to a delivery unit 535. Thesurgical instrument 500 may be generally similar to surgical instrument100 described above. For example, among other things, the surgicalinstrument 500 may comprise a handle 505 and a cutting member 540operably coupled together. However, various components of the surgicalinstrument 500 are omitted for clarity. For instance, an elongate shaftoperably coupled to the handle as well as additional components of anend effector operably coupled to the elongate shaft are not illustratedin FIG. 13.

In more detail, the surgical instrument 500 may comprise a trigger orlever arm 528 that may be movable with respect to a handle body 506B.Moving the arm 528 may correspondingly move an extension 527 formed onan upper portion of the arm 528, thereby causing a shuttle 546 to movein a proximal or distal direction. The shuttle 546 may be operablycoupled to the cutting member 540. Accordingly, movement of the leverarm 528 may cause the cutting member 540 to translate with respect tothe handle 505 and/or a jaw or jaws (not shown), for example.

The cutting member 540 may be coupled to a handle cable 538 eitherdirectly or via a passage in shuttle 546. In any event, the handle cable538 may be coupled to a strain relief 539. Outside the handle 505,strain relief 539 may couple the handle tube 538 to a fluid cable 536within an exterior cable 537. The exterior cable 537 may contain boththe fluid cable 536 and a power cable 552, which both may be releasablycoupled to the delivery unit 535.

The delivery unit 535 may comprise electrical source 145 and controller150 electrically coupled to the power cable 552, as discussed above withrespect to cable 152. Additionally, the delivery unit 535 may comprise afluid chamber 580 holding water, distilled water, saline solution and/orany other suitable biocompatible fluid. The delivery unit 535 mayfurther comprise a pump (not shown) configured to draw fluid out of thechamber 580 and deliver the fluid through the cables 536, 537, and 538and into and through cutting member 540.

The cutting member 540 may comprise a body 555 and a cutting surface 553at a distal portion of the body 555. The body 555 may define a cavity547 and at least one opening 548 communicating with the cavity 547. Theopening 548 may be proximal to the cutting surface 553. Accordingly, thefluid chamber 580 may be operably coupled to the cutting member cavity547 such that the delivery unit 535 may move a fluid from chamber 580,to cutting member 540, and out openings 548, thereby cooling ordissipating heat from the cutting member 540, an end effector (notshown), and/or tissue.

In at least one embodiment, as discussed above, the fluid chamber 580may be located outside the handle 505. However, in various embodiments,a fluid chamber may be located within a surgical instrument's handle.For example, referring now to FIG. 14, in at least one embodiment, asurgical instrument 600 may comprise a handle 605 containing a fluidchamber 680 therein. The surgical instrument 600 may be similar tosurgical instrument 100 described above; however, various components ofinstrument 600 are omitted from FIG. 14 for clarity. For example, jawsof an end effector are not illustrated.

In more detail, the surgical instrument 600 may comprise a trigger orlever arm 628 that may be movable with respect to a handle body 606B.Moving the arm 628 may correspondingly move an extension (not shown)formed on an upper portion of the arm 628, thereby causing a shuttle 646to move in a proximal or distal direction. The shuttle 646 may beoperably coupled to the cutting member 640. Additionally, the chamber680 may be fixedly connected to the handle body 606B and a piston orplunger 682 may be movably positioned within the chamber 680. Thecutting member 640 may be coupled to the plunger 682 through a passagein shuttle 646. Accordingly, movement of the lever arm 628 may cause thecutting member 640 and/or plunger 682 to translate with respect to thehandle body 606B, fluid chamber 680 and/or a jaw or jaws (not shown),for example.

Further, referring still to FIG. 14, the cutting member 640 may comprisea body 655 and a cutting surface (not shown) at a distal portion of thebody 655. The body 655 may define a cavity 647 and at least one distalopening near the cutting surface communicating with the cavity 647.Further, the cavity 647 may be coupled to a tubing 683 at a proximalhole 649 formed in the body 655 of the cutting member, proximal to thedistal opening or openings (not shown). The tubing 683 may traverse theelongate shaft 608 into the handle body 606B to ultimately connect tothe fluid chamber 680 at a port 681. Accordingly, the fluid chamber 680may be operably coupled to the cutting member cavity 647 such that afluid may be moved from or to chamber 680, to or from cutting member640, and out or in the opening(s), thereby cooling or dissipating heatfrom the cutting member 640, an end effector (not shown), and/or tissue.

In more detail, in various embodiments, the fluid chamber 680 may beconfigured to move or draw a fluid through the cutting member 640. Forexample, in at least one embodiment, the plunger 682 may be moved in aproximal direction, such as that designated by arrow “P,” by operatingthe lever arm 628 such that the shuttle 646 causes the cutting member640 and hence the plunger 682 to move in a proximal direction. In suchembodiments, a fluid, comprising a gas and/or a liquid, such as carbondioxide and/or saline solution, for example, may be forced out of thechamber 680 by the proximally moving plunger 682 and into and throughthe cutting member cavity 647 via tubing 683. Moreover, because thecutting member 640 and the plunger 682 are coupled together as shown,any cooling fluid may be driven out of the chamber 680 and through thecutting member 640 when the cutting member 640 is moved in a proximaldirection. Thus, heat dissipation from a cooling fluid may be configuredto occur after a cutting action is complete, when the cutting member 640is returning to an initial, proximal position.

Alternatively, in at least one embodiment, the fluid chamber 680 mayreceive fluid drawn from an end effector, for example. In suchembodiments, the plunger 682 may initially, before being actuated, belocated at a proximal position within the chamber 680. The plunger 682may then be moved in a distal direction, such as that designated byarrow “D,” by operating the lever arm 628 such that the shuttle 646causes the cutting member 640 and hence the plunger 682 to move in adistal direction, thereby creating a vacuum or lower pressure statewithin the fluid chamber 680. Such vacuum pressure may thereby cause afluid, comprising gas, steam, water vapor, and/or liquid, for example,to be drawn into the cutting member cavity 647 via the distal openingsnear the cutting surface and/or end effector (not shown), for example.Thereafter, the drawn fluid may be forced into fluid chamber 680 throughtubing 683.

In some embodiments, it may be desirable to evacuate fluid out of thesurgical instrument 600. Accordingly, in at least one embodiment,referring still to FIG. 14, the surgical instrument 600 may furthercomprise a three-way valve 684 located inline with the tubing 683 andwithin the handle 605. In at least one embodiment, the valve 684 maycomprise a bi-directional double check valve such as that manufacturedby Value Plastics, Inc. of Fort Collins, Colo. In any event, two portsof the valve 684 may be coupled to different portions of the tubing 683and one port of the valve 684 may be coupled to an exhaust 686 formed inthe handle body 606B. The valve 684 may be configured to allowvacuum-pressure to be applied from the fluid chamber 684 to the cuttingmember cavity 647 through tubing 683. However, owing to the presence ofthe valve 684, fluid drawn from the end effector (not shown), throughthe cavity 647, and proximally through the tubing 683, may be divertedfrom the tubing 683 at valve 684 and expelled from the instrument 600through the exhaust 686. Accordingly, in such embodiments, the surgicalinstrument 600 may be used multiple times since the fluid chamber 680may not fill with fluid.

In various embodiments described herein, a fluid may be used to helpdissipate heat from an end effector of a surgical instrument and/ortissue. In such embodiments, the fluid may comprise a liquid, such asdistilled water and/or saline solution, for example. Further, in atleast one embodiment, the liquid may be injected through a surgicalinstrument's jaws in a fashion similar to a steam iron. Accordingly, thetarget tissue may be kept hydrated during the sealing or weldingprocess. Moisture in the tissue may help buffer the tissue such that thetissue's temperature remains at or around the temperature of the liquid,which may be boiling. Alternatively or additionally, the liquid maycomprise nano-particles that are configured to absorb and store heat. Inat least one embodiment, the nano-particles may be in suspension withina liquid, such as distilled water and/or saline solution, for example.The nano-particles may further help maintain tissue at a desired sealingtemperature, for example, via a phase change of chemicals encapsulatedin microspheres, for example. Further, in at least one embodiment, afterthe sealing process is complete, the nano-particles may be configured to(1) disperse through evaporation or out-gassing, for example, (2)biodegrade by breaking down and being absorbed and/or carried away bythe patient's body, for example, and/or (3) remain inert and embedded inthe tissue without compromising the strength of the tissue seal, forexample.

Additional embodiments of surgical instruments may dissipate heatgenerated within an end effector and/or tissue. For example, in variousembodiments, referring to FIGS. 15 and 16, portions of an end effector710 of a surgical instrument 700 are illustrated. The end effector 710may be generally similar to end effector 110 described above. Forexample, among other things, the end effector 710 may comprise a firstjaw 720A and a second jaw 720B operably coupled together and supportinga cutting member 740 therein. However, the cutting member 740 may befixedly attached to one of the jaws 720A or 720B. Here, the cuttingmember 740 is shown fixed to second jaw 720B. Each jaw 720A, 720B mayfurther comprise an energy delivery surface 775A and 775B and anexterior surface 776A and 776B, respectively. Accordingly, tissue “T”may be cut and sealed when the jaws 720A, 720B rotate from an openposition (see FIG. 3) to a closed position (see FIG. 4) and energy isapplied between surfaces 775A and 775B.

Either or both of the jaws 720A and 720B may further comprise open orexposed grooves 780A and 780B, respectively. The grooves 775A and 775Bmay be defined in the surfaces of the jaws 720A, 720B adjacent to energydelivery surfaces 775A and 775B. Further, the grooves 780A, 780B mayeach extend around the perimeter of the surfaces 775A, 775B,respectively. Moreover, each groove 780A and 780B may be positionedbetween an energy delivery surface 775A or 775B and an exterior surface776A or 776B, within each respective jaw 720A and 720B.

In at least one embodiment, the grooves 780A, 780B may help evacuateheat and/or steam, for example, generated during energy delivery to theend effector 710. In such embodiments, the grooves 780A, 780B may be influid communication with a vacuum 782. The vacuum may help draw steam,water vapor, gas, liquid, or any other fluid, in directions generallydesignated by arrows 783 into the grooves 780A, 780B and into anelongate shaft (not shown) of the surgical instrument 700. Accordingly,such heated substances may escape the end effector 710 or tissue nearthe end effector 710.

Alternatively or additionally to the vacuum 782, the grooves 780A, 780Bmay be in fluid communication with a fluid source 781. The fluid source781 may provide a gas, such as carbon dioxide, for example. In at leastone embodiment, the fluid source may comprise an insufflation apparatusof a type typically used during a laparoscopic procedure, for example.The fluid source 781 may provide a continuous stream of gas to thegrooves 780A, 780B such that the end effector 710 and/or tissue T may becooled. As mentioned above, the fluid source 781 may provide a gas;however, in at least one embodiment, the fluid source may provide aliquid, such as a saline solution, for example. In such embodiments, thefluid source 781 may pump the liquid into the grooves 780A, 780B from anexternal reservoir, thereby continuously bathing the tissue T in achilled or cooled medium. Also, in at least one embodiment, the fluidmay comprise a gel or a two-part endothermic mixture, such as watermixed with potassium chloride, citric acid mixed with sodiumbicarbonate, and/or ammonium chloride mixed with water, for example.

In various embodiments, a surgical instrument may comprise a heat sinkthat may assist in dissipating heat from an end effector and/or tissue.For example, in at least one embodiment and referring to FIG. 17, aportion of an end effector 810 of a surgical instrument 800 is shown.The surgical instrument 800 may be generally similar to surgicalinstrument 700 described above. For example, among other things, the endeffector 810 may comprise first and second jaws 820A and 820B that areoperably coupled together. Each jaw 820A, 820B may comprise an energydelivery surface, such as energy delivery surfaces 875A and 875B, forexample. A cutting member 840 may also be fixedly coupled to a jaw, suchas jaw 820B, for example. However, the first jaw 820A may furthercomprise a heat sink, such as heat sink 880. In at least one embodiment,the heat sink 880 may be embedded in the first jaw 820A and may beexposed through an exterior surface 876A of the first jaw 820A. The heatsink 880 may comprise a heat conductive material, such as a metal, likealuminum, and/or a ceramic material, for example.

In various embodiments, one or both of a surgical instrument's jaws maycomprise a heat sink. For example, referring back to FIG. 16, thegrooves 780A and/or 780B may contain and/or comprise a heat sink, whichmay comprise a heat conductive material, such as a metal, like aluminum,and/or a ceramic material, for example. Further, referring to FIG. 18,another embodiment of a portion of an end effector 910 of a surgicalinstrument 900 is shown. The surgical instrument 900 may be generallysimilar to surgical instrument 100 described above. For example, amongother things, the end effector 910 may comprise a first jaw 920A and asecond jaw 920B operably coupled together and movably supporting acutting member 940. Each jaw 920A, 920B may also comprise an energydelivery surface 975A and 975B, respectively. However, the first jaw920A may comprise a first heat sink 980A embedded therein and the secondjaw 920B may comprise a second heat sink 980B embedded therein. Eachheat sink 980A, 980B may be tubular in shape and extend to both sides ofcutting member 940 such that heat may be effectively dissipated throughthe jaws 920A, 920B. Additionally, each heat sink 980A, 980B maycomprise a heat conductive material, such as a metal, like aluminum,and/or a ceramic material, for example. In any event, in variousembodiments including a heat sink, the heat sink may help efficientlytransfer heat from tissue captured within an end effector's jaws awayfrom the tissue and toward an elongate shaft of the surgical instrument,for example. In at least one embodiment, a heat sink may allow heat toequilibrate and/or dissipate throughout an extended length equal to orgreater than the length of a jaw or jaws in contact with the tissue.

In various embodiments, a heat sink may comprise a Peltier device.Referring now to FIG. 19, a cross-sectional view of jaws 1220A and 1220Bof an end effector 1210 of a surgical instrument 1200 are illustrated.The surgical instrument 1200 may be generally similar to the surgicalinstrument 100 described above. For example, among other things, the endeffector 1200 may comprise the jaws 1220A and 1220B, which may beoperably coupled together. Each jaw 1220A and 1220B may comprise anenergy delivery surface 1275A and 1275B, respectively. Additionally, atleast one jaw, for example, jaw 1220B may comprise at least one Peltierdevice, such as a first Peltier device 1281 and/or a second Peltierdevice 1282, either or both of which may be positioned adjacent to theenergy delivery surface 1275B. A Peltier device may comprise asolid-state thermoelectric cooler. Additionally, a Peltier device mayfunction on the principle that when a voltage differential is applied toa thermocouple-like device, a temperature differential may be createdbetween two sides of the device.

In more detail, referring now to FIG. 20, each Peltier device, such asPeltier device 1281, for example, may comprise a first section 1281 aand a second section 1281 b. The sections 1281 a and 1281 b may have avoltage differential applied between them by a voltage source “V.” Asthe voltage source V applies a voltage differential between the firstsection 1281 a and the second section 1281 b, heat energy may be movedfrom the first section 1281 a to the second section 1281 b.

Referring now to FIG. 21, a perspective sectional view of a portion ofthe jaw 1220B is shown. The Peltier devices 1281 and 1282 can be seen onthe perimeter of the jaw 1220B, adjacent to the energy delivery surface1275B. In at least one embodiment, the first section 1281 a of the firstPeliter device 1281 may be flush with the energy delivery surface 1275Band the second section 1281 b may contact an interior surface of the jaw1220B. Thus, when a voltage differential is applied to a Peltier device,such as Peltier device 1281, for example, heat may be moved from thefirst section 1281 a to the second section 1281 b and to the jaw 1220B,away from any tissue gripped by the jaw 1220B and/or energy deliverysurface 1275B. Further, the Peltier device 1282 may be similar to thePeltier device 1281 described above. Additionally, the third and fourthPeltier devices 1283, 1285, may extend transversely from the firstPeltier device 1281, and the fifth and sixth Peltier devices 1284, 1286may extend transversely from the second Peltier device 1282. Thesetransverse Peltier devices 1283, 1284, 1285, 1286 may further dissipateheat energy from tissue clamped between the jaws 1220A, 1220B (FIG. 19)and/or away from energy delivery surface 1275B, over that provided bylongitudinal Peltier devices 1281 and/or 1282, to help prevent or resistundesired thermal alteration of tissue. In various embodiments,additional transverse Peltier devices and/or longitudinal Peltierdevices may be added to the first jaw 1220A and/or the second jaw 1220Bto provide additional heat dissipation. Additionally, in at least oneembodiment, the Peltier devices may be instantly turned on and off atdesired intervals and/or regulated in a linear fashion.

FIGS. 22-23 illustrate an embodiment of another surgical instrument 1300comprising an end effector 1310 and a Peltier device 1380. FIG. 22 is across-sectional view of the end effector 1310 and FIG. 23 is aperspective view of a portion of a jaw of the end effector 1310. Invarious embodiments, the surgical device 1300 may be generally similarto surgical device 100 described above in that the end effector 1310 maycomprise two jaws 1320A and 1320B operably coupled together. However,the surgical device 1300 may function as a tissue spot welder and maynot include a cutting member. The jaws 1320A and 1320B may compriseenergy delivery surfaces 1375A and 1375B, respectively. Adjacent toand/or flush with the energy delivery surface 1375B may be the Peltierdevice 1380. The Peltier device 1380 may further extend around theentire perimeter of the energy delivery surface 1375B, to enhance theheat dissipation therefrom. Similar to Peltier device 1281 describedabove, Peltier device 1380 may comprise a first section 1380 a and asecond section 1380 b. The sections 1380 a and 1380 b may be configuredto receive a voltage differential between them from a voltage source“V.” As the voltage source V applies a voltage differential between thefirst section 1380 a and the second section 1380 b, heat energy may bemoved from the first section 1380 a to the second section 1380 b,thereby transferring and/or dissipating heat away from the energydelivery surface 1375B and/or tissue held between jaws 1320A and 1320B.

In various embodiments, heat dissipation from an end effector of asurgical instrument may be assisted by at least one heat pipe. In atleast one embodiment, referring now to FIG. 24, the distal portion of asurgical instrument 1000 is shown. The surgical instrument 1000 may begenerally similar to surgical instrument 100 described above. Forexample, among other things, the surgical instrument may comprise an endeffector 1010 operably coupled to an elongate shaft 1008. The endeffector 1010 may comprise a first jaw 1020A and a second jaw 1020Boperably coupled together. The jaws 1020A and 1020B may be movablebetween an open configuration, such as that shown in FIG. 24, forexample, and a closed configuration. Further, referring to FIG. 25,which shows a cross-sectional view of the end effector with the jaws1020A and 1020B in a closed configuration, the end effector 1010 maycomprise a cutting member 1040 that is configured to translate withrespect to the jaws 1020A, 1020B. However, the end effector 1010 mayalso comprise at least one heat pipe, such as heat pipes 1081 and 1082.The heat pipes 1081, 1082 may be attached to the first jaw and extendproximally therefrom, through or next to elongate shaft 1008.Additionally, the heat pipes 1081, 1082 may be adjacent to the first jaw1020A and may reside on opposing sides of the cutting member 1040.

In more detail, referring to FIG. 26, which shows a cross-sectionalportion of the heat pipe 1081, the heat pipe 1081 may comprise an outershell 1083 and an inner porous material 1084 defining an internal cavity1085. The cavity 1085 may be sealed within the outer shell 1083 and maybe partially evacuated and contain a heat transfer fluid 1086. Asillustrated in FIG. 26, portions of the outer shell 1083 and the innerporous material 1084 have been cross-sectioned to show inner portions ofthe heat pipe 1081. In at least one embodiment, the outer shell 1083 ofthe heat pipe can be made of a thermally conductive and biocompatiblemetallic material positioned in direct contact with the jaw 1020A (FIG.25). When the temperature of the jaw 1020A rises during energy delivery,as discussed above, the heat transfer fluid 1086 closest to the activejaw 1020A starts to evaporate, filling the internal cavity with vapor.The vapor condenses as it is forced proximally by a vapor pressuregradient, in a direction generally designated as “P,” toward a proximalportion of the heat pipe 1081, which may be thermally connected to aheat sink, for example. The resulting liquid may then flow distally, ina direction generally designated as “D,” via wicking propertiesassociated with the inner porous material 1084. Accordingly, heat may becontinuously carried away from the energized jaws 1020A, 1020B, in aproximal direction P, to decrease the working temperature between thejaws 1020A, 1020B. In various embodiments, the heat transfer fluid 1086may be selected based on a desired working temperature. For example, theheat transfer fluid may comprise water and/or water-soluble (diluted)hydrocarbons. In at least one embodiment, the heat transfer fluid maycomprise 30% ethanol and 70% water, for example. Additional detailsregarding an exemplary heat pipe or heat pipes may be found in U.S. Pat.No. 7,235,073, incorporated in its entirety by reference herein.

While the heat pipe(s) described above may be attached to one or both ofthe jaws, a heat pipe according to various embodiments may alternativelyor additionally be attached to a cutting member. Accordingly, in atleast one embodiment and referring now to FIG. 27, various portions of asurgical instrument 1100 are illustrated. The surgical instrument 1100may be generally similar to surgical instrument 100 described above. Forexample, among other things, the surgical instrument may comprise an endeffector 1110 and a handle 1105 operably coupled together by an elongateshaft 1108. The end effector 1110 may comprise a first jaw 1120A and asecond jaw 1120B pivotably connected to each other. The end effector1110 may further movably support a cutting member 1140 therein. In moredetail, FIG. 28 depicts a partial side cross-sectional view of a portionof the surgical instrument 1100, taken along line 28-28 in FIG. 27, withthe jaws 1120A and 1120B omitted for clarity. The cutting member 1140may comprise a body 1155 and a cutting surface 1153 located at a distalportion of the body. Moreover, a heat pipe 1180 may be attached to thecutting member 1140. For example, in various embodiments, the heat pipe1180 may be positioned within or attached to the exterior of the body1155. Accordingly, in at least one embodiment, the heat pipe 1180 may bemoved, relative to the jaws 1120A, 1120B, for example, when the cuttingmember 1140 is likewise moved. Also, in various embodiments, the heatpipe 1180 may extend along a portion of the body 1155. As illustrated inFIG. 28 and in at least one embodiment, the heat pipe 1180 may extendinto the handle 1105, such that heat may be evacuated thereto. Asillustrated in FIGS. 27-28, end portions of the heat pipe 1180 have beencross-sectioned to show inner portions of the heat pipe 1081; however itis to be understood that the heat pipe 1180 may be completely sealed atboth ends. Further, in at least one embodiment, the heat pipe 1180 maybe similar to the heat pipes 1081, 1082, described above.

In use and in at least one embodiment, referring to FIGS. 27 and 28,tissue “T” may be clamped between jaws 1120A, 1120B. Thereafter, thejaws 1120A, 1120B may be energized as described above with regard tosurgical instrument 100, thereby creating a tissue weld “TW” in thetissue T. The cutting member 1140 may concurrently or thereafter beadvanced through the tissue T, severing it. Additionally, as the cuttingmember 1140 is advanced, any heat built up in the end effector 1110,cutting member 1140, tissue T, and/or tissue weld TW, may be transportedproximally via heat pipe 1180, thereby dissipating heat from the endeffector 1110, cutting member 1140, tissue T, and/or tissue weld TW, forexample.

Among other things, various heat dissipation means have been describedabove for dissipating heat from at least a portion of an end effector ofa surgical instrument and/or tissue, for example. However, additionalheat dissipation means, used independently, or in addition to one ormore of the above described heat dissipation means, may also provide forenhanced heat dissipation of at least a portion of an end effector.Accordingly, in various embodiments, referring again to FIGS. 1 and 3, asurgical instrument, such as surgical instrument 100 seen in FIG. 1, maycomprise an end effector 110 comprising at least one energy deliverysurface, such as one or both energy delivery surfaces 175A and 175B seenin FIG. 3, and a heat dissipation means for dissipating heat from atleast a portion of the end effector.

In at least one embodiment, the heat dissipation means may comprise agas container. Referring now to FIG. 29, a surgical instrument 1400 maybe generally similar to surgical instrument 100 described above. Forexample, among other things, the surgical instrument 1400 may comprise ahandle 1405 and an elongate shaft 108 operably coupling the handle 1405to the end effector 110 (FIG. 3). A gas container, such as gas container1480, for example, may be operably coupled to the handle 1405. Forexample, as shown, the gas container 1480 may be fixedly attached to thehandle inside the handle body 1406B. Alternatively, the gas container1480 may be positioned outside the handle body 1406B. Further, the gascontainer 1480 may be configured to selectively release a gas such thatthe gas moves through the elongate shaft 108, in a distal direction,such as that demarcated by arrows 1486, and to at least a portion of theend effector 110 (FIG. 3), thereby dissipating heat from at least aportion of the end effector 110 and/or tissue.

In more detail, the gas container 1480 may include an outlet 1480B thatis connected to a tubing 1483. The tubing 1483 may also be connected toa proximal hole 149 of a cutting member 140 as described above. The gascontainer 1480 may hold a compressed gas therein that may be releasedwhen a user presses a control button (not shown) that is configured toelectrically and/or mechanically open outlet 1480B such that thecompressed gas may escape the container 1480 into tubing 1483 andultimately into the cutting member 140, for example. Alternatively, theoutlet 1480B may be opened automatically before, during, and/or afteractivation of the energy deliver surfaces 175A, 175B (FIG. 3) viaactivation button 124. In various embodiments, the gas may be abiocompatible gas such as carbon dioxide, for example. When thecompressed gas escapes to the environment outside the gas container1480, the expanded gas may drop in temperature, thereby providing acooled gas to the end effector 110 and/or tissue via the cutting member140, as described above with respect to surgical instrument 100.Alternatively, in various embodiments, the gas may be routed internallythrough conduits enclosed within the jaws and/or electrodes, as a closedsystem, or externally such that the gas is piped to the sealing site andthen released through orifices, such as openings 148 (FIG. 5) in thecutting member 140, to escape to the atmosphere, as an open system, orthrough a combination of the two routes. The flow of the gas out of thegas container 1480 may be initiated after sealing tissue, and in atleast one embodiment, prior to opening the jaws 120A, 120B (FIG. 4)after sealing tissue, for example.

In at least one embodiment, the heat dissipation means may comprise avortex tube. Referring now to FIG. 30, a surgical instrument 1500 may begenerally similar to surgical instrument 100 described above. Forexample, among other things, the surgical instrument 1500 may comprise ahandle 1505 and an elongate shaft 108 operably coupling the handle 1505to the end effector 110 (FIG. 3). A vortex tube, such as vortex tube1580, for example, may be operably coupled to the handle 1505. Forexample, as shown, the vortex tube 1580 may be fixedly attached to thehandle 1505 outside the handle body 1506B. Alternatively, the vortextube 1580 may be positioned inside the handle body 1506B. Further, thevortex tube 1580 may be configured to expel a cooled gas such that thegas moves through the elongate shaft 108, in a distal direction, such asthat demarcated by arrows 1586, and to at least a portion of the endeffector 110 (FIG. 3), thereby dissipating heat from at least a portionof the end effector 110 and/or tissue.

In more detail, referring to both FIGS. 30 and 31, the vortex tube 1580may comprise a body 1587 including an inlet 1582 and two outlets, warmexhaust or outlet 1585 and cool outlet 1584. The cool outlet 1584 may beconnected to a port 1589 in the handle body 1505 that is connected to atubing 1583. The tubing 1583 may also be connected to a proximal hole149 of a cutting member 140 as described above. Additionally, the inlet1582 may be connected to a gas container 1581 at a gas outlet 1581B. Thegas container 1581 may be fixedly mounted to the handle body 1506B. Thegas container may be generally similar to gas container 1480, describedabove. For example, among other things, the gas container 1581 may holda compressed gas therein that may be released when a user presses acontrol button (not shown) that is configured to electrically and/ormechanically open outlet 1581B such that the compressed gas may escapethe container 1581 into the vortex tube 1580 via inlet 1582. Also,alternatively, the outlet 1581B may be opened automatically before,during, and/or after activation of the energy deliver surfaces 175A,175B (FIG. 3) via activation button 124. In various embodiments, the gasmay be a biocompatible gas such as carbon dioxide, for example.

The vortex tube 1580 may be a Ranque-Hilsch vortex tube (manufactured byExAir Corporation of Cincinnati, Ohio, for example) that is configuredto create a cold and hot gas stream utilizing few or no moving parts,for example. Referring to FIG. 31, the vortex tube 1580 is shown inisolation from the other components of surgical instrument 1500. Asillustrated, gas may enter the vortex tube via inlet 1582 at a firsttemperature T1. The gas may then travel in a helical manner within thebody 1587 of the vortex tube 1580 toward warm outlet 1585. Upon nearingthe warm outlet 1585, the moving gas may contact a conical nozzle 1588that is sized and configured to cause warmer gas to be expelled throughthe warm outlet 1585, at a second temperature T2, and force cooler gasto be returned toward the cool outlet 1584. Upon reaching the cooloutlet 1584, cooler gas may be expelled from the cool outlet 1584 at athird temperature T3. The third temperature T3 may be lower than thefirst and/or second temperatures T1 and T2, respectively. Accordingly,the vortex tube 1580 may create a cooler gas than that otherwise createdfrom gas escaping the gas container 1581 without the assistance of thevortex tube 1580.

Referring again to FIG. 30, after gas is released into the vortex tube1580 from the gas container 1581, a warm gas may be expelled from thewarm outlet 1585 and a cooled gas may be expelled from the cool outlet1584, as explained above. From the cool outlet 1584, gas may travelthrough the port 1589 and the tubing 1583, and into the cutting member140 via proximal hole 149. Thereafter, gas may move through the cuttingmember 140 and/or elongate shaft 108 to at least a portion of the endeffector 110 (FIG. 3), thereby dissipating heat therefrom, for example.In such embodiments, the cooled gas may be considered to be appliedinternally to the end effector 110, as the gas may be expelled from thecutting member 140 at distal openings, such as openings 148 (FIG. 5),for example. Alternatively, in at least one embodiment, the cooled gasmay be applied externally to the jaws, via the elongate shaft 108, forexample. Further, in at least one embodiment, cooled gas may be appliedboth internally and externally to the jaws. Additionally, while thevortex tube 1580 and/or gas container 1581 is shown directly attached tothe handle body 1506B in FIG. 30, either or both the vortex tube and thegas container 1581 may be located in an auxiliary device, connected tothe surgical device 1500 by a flexible tube, for example.

In at least one embodiment, the heat dissipation means may comprise anair cycle machine. In such embodiments, a surgical instrument (notshown) may be generally similar to instrument 100 described above. Forexample, the surgical instrument may comprise a handle and an elongateshaft operably coupling the handle to the end effector 110 (see FIG. 3).An air cycle machine may be operably coupled to the handle via a tube,for example. Further, the air cycle machine may be configured to expel acooled gas such that the gas moves through the elongate shaft to atleast a portion of the end effector 110 (FIG. 3), thereby dissipatingheat from at least a portion of the end effector 110 and/or tissue. Insuch embodiments, the air cycle machine may be a miniaturized adaptationof an air cycle machine commonly used as a refrigeration unit on aturbine-powered aircraft. Accordingly, the air cycle machine may providechilled gas, such as air, for example, to the end effector 110, jaws120A, 120B (FIG. 3), and/or tissue. Briefly, the principle of operationof an air cycle machine is based upon the expansion of a compressed gasand may utilize an expansion turbine to extract work from the gas as itis being cooled. The turbine may concurrently run a compressor which mayboost the compression of the gas upstream.

In at least one embodiment, the heat dissipation means may comprise roomtemperature distilled water circulated through the jaws of a surgicalinstrument in a single-pass fashion and/or released externally onto jawsof a surgical instrument and/or tissue at the completion of the sealingprocess. The surgical instrument of such an embodiment or embodimentsmay be generally similar to surgical instrument 100, described above.Further, such heat dissipation means may provide quick cooling of atleast a portion of an end effector and/or tissue, for example.

In at least one embodiment, the heat dissipation means may comprise aclosed-loop, refrigerant-based cooling system. Such a system may cool asurgical instrument's jaws following the completion of tissue sealing.The surgical instrument may be generally similar to surgical instrument100, as described above. Additionally, the cooling system may include anevaporator coil that may be routed directly through the surgicalinstrument's jaws to provide efficient heat transfer.

In at least one embodiment, the heat dissipation means may comprise acooled liquid created by a chemical function, such as a heat of solutionand/or an endothermic chemical reaction, for example. The cooled liquidmay be circulated through a surgical instrument's jaws immediatelyfollowing the completion of tissue sealing by the instrument, forexample. In such embodiments, the surgical instrument may be generallysimilar to surgical instrument 100, described above. In at least oneembodiment, the cooled liquid may be created by mixing ammonium nitrateor potassium chlorate with water to produce a desired cooling effect.

In at least one embodiment, the heat dissipation means may comprise amagnetic refrigeration system. In such embodiments, a magneticrefrigeration system may be based on the magnetocaloric effect toprovide cooling directly and/or indirectly, through, for example, achilled working fluid, to a surgical instrument's jaws following thecompletion of tissue sealing by the instrument, for example. Such asystem may utilize an alloy or alloys such asgadolinium-silicon-germanium (Gd₅(Si₂Ge₂)), for example. Additionalinformation regarding such magnetic refrigeration may be found in thefollowing article: Kerry Gibson, Magnetic refrigerator successfullytested, U.S. Department of Energy RESEARCH NEWS, athttp://www.eurekalert.org/features/doe/2001-11/dl -mrs062802.php (Nov.1, 2001).

In at least one embodiment, the heat dissipation means may comprise oneor more thermoacoustic refrigeration devices. In such embodiments, atleast one thermoacoustic device may rapidly cool a surgical instrument'sjaws following the completion of tissue sealing by the instrument, forexample. In such embodiments, the surgical instrument may be generallysimilar to surgical instrument 100, described above. In at least oneembodiment, each thermoacoustic device may be a relatively small tubulardevice with few or no moving parts, which may use acoustic and/orultrasonic energy to pump heat away from the surgical instrument's jaws.Additionally, the thermoacoustic devices may be cylindrical and/or arering-shaped such that they have a recirculating configuration.

As noted above, the particular features, structures, or characteristicsdescribed herein may be combined in any suitable manner in one or moreembodiments. Thus, the particular features, structures, orcharacteristics illustrated or described in connection with oneembodiment may be combined, in whole or in part, with the featuresstructures, or characteristics of one or more other embodiments withoutlimitation. For example, at least one of the above embodiments describesa blade-based cooling mechanism and at least one embodiment describes ajaw-based cooling mechanism. In at least one embodiment, thesemechanisms may be employed in a single instrument, for example.

The embodiments of the devices described herein may be introduced insidea patient using minimally invasive or open surgical techniques. In someinstances it may be advantageous to introduce the devices inside thepatient using a combination of minimally invasive and open surgicaltechniques. Minimally invasive techniques may provide more accurate andeffective access to the treatment region for diagnostic and treatmentprocedures. To reach internal treatment regions within the patient, thedevices described herein may be inserted laparoscopically, such as in amultiple site laparoscopy, a single site laparoscopy, or a singleincision laparoscopic surgery, for example. Further, the devicesdescribed here may be used in a a single port access procedure, forexample. Additionally or alternatively, the devices described herein maybe inserted through natural openings of the body such as the mouth,anus, and/or vagina, for example. Minimally invasive proceduresperformed by the introduction of various medical devices into thepatient through a natural opening of the patient are known in the art asNOTES™ procedures. Some portions of the devices may be introduced to thetissue treatment region percutaneously or throughsmall—keyhole—incisions.

Endoscopic minimally invasive surgical and diagnostic medical proceduresare used to evaluate and treat internal organs by inserting a small tubeinto the body. The endoscope may have a rigid or a flexible tube. Aflexible endoscope may be introduced either through a natural bodyopening (e.g., mouth, anus, and/or vagina) or via a trocar through arelatively small—keyhole—incision (usually 0.5-1.5 cm). The endoscopecan be used to observe surface conditions of internal organs, includingabnormal or diseased tissue such as lesions and other surface conditionsand capture images for visual inspection and photography. The endoscopemay be adapted and configured with working channels for introducingmedical instruments to the treatment region for taking biopsies,retrieving foreign objects, and/or performing surgical procedures.

The devices disclosed herein may be designed to be disposed of after asingle use, or they may be designed to be used multiple times. In eithercase, however, the device may be reconditioned for reuse after at leastone use. Reconditioning may include a combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicemay be disassembled, and any number of particular pieces or parts of thedevice may be selectively replaced or removed in any combination. Uponcleaning and/or replacement of particular parts, the device may bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Those ofordinary skill in the art will appreciate that the reconditioning of adevice may utilize a variety of different techniques for disassembly,cleaning/replacement, and reassembly. Use of such techniques, and theresulting reconditioned device, are all within the scope of thisapplication.

Preferably, the various embodiments of the devices described herein willbe processed before surgery. First, a new or used instrument is obtainedand if necessary cleaned. The instrument can then be sterilized. In onesterilization technique, the instrument is placed in a closed and sealedcontainer, such as a plastic or TYVEK® bag. The container and instrumentare then placed in a field of radiation that can penetrate thecontainer, such as gamma radiation, x-rays, or high-energy electrons.The radiation kills bacteria on the instrument and in the container. Thesterilized instrument can then be stored in the sterile container. Thesealed container keeps the instrument sterile until it is opened in themedical facility. Other sterilization techniques can be done by anynumber of ways known to those skilled in the art including beta or gammaradiation, ethylene oxide, and/or steam.

Although the various embodiments of the devices have been describedherein in connection with certain disclosed embodiments, manymodifications and variations to those embodiments may be implemented.For example, different types of end effectors may be employed. Also,where materials are disclosed for certain components, other materialsmay be used. The foregoing description and following claims are intendedto cover all such modification and variations.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

What is claimed is:
 1. A surgical instrument, comprising: an endeffector comprising: a first jaw comprising an electrode having a distalend; a second jaw, wherein the first jaw and the second jaw are operablycoupled together; and a cutting member configured to translate between aretracted position and a fully advanced position with respect to thefirst jaw, wherein the cutting member comprises a cutting surface and abody, wherein the body defines a cavity and at least one openingcommunicating with the cavity, and wherein the at least one cuttingmember opening is proximal to the distal end of the electrode when thecutting member is in the fully advanced position.
 2. The surgicalinstrument of claim 1, further comprising an elongate shaft and a handleoperably coupled to the elongate shaft, wherein the end effector isoperably coupled to the elongate shaft, and wherein the at least onecutting member opening is positioned between the handle and the cuttingsurface.
 3. The surgical instrument of claim 1, wherein the cuttingmember defines a longitudinal axis and wherein the at least one openingdefines a plane that is parallel to the longitudinal axis.
 4. Thesurgical instrument of claim 1, wherein the cutting member defines alongitudinal axis and wherein the at least one opening defines a planethat intersects the longitudinal axis.
 5. The surgical instrument ofclaim 1, further comprising a porous material positioned within the atleast one opening.
 6. The surgical instrument of claim 1, furthercomprising: an elongate shaft; a handle operably coupled to the elongateshaft, wherein the end effector is operably coupled to the elongateshaft; and a fluid chamber operably coupled to the cutting membercavity.
 7. The surgical instrument of claim 6, further comprising aplunger movable within the chamber.
 8. The surgical instrument of claim6, wherein the fluid chamber contains at least one gas and/or liquid. 9.The surgical instrument of claim 6, the fluid chamber contains at leastone liquid, wherein the at least one liquid comprises nano-particlesthat are configured to absorb and store heat.
 10. A surgical instrument,comprising: an end effector comprising: a first jaw; a second jaw,wherein the first jaw and the second jaw are operably coupled together;and a cutting member configured to translate with respect to the firstjaw, wherein the cutting member comprises a cutting surface and a body,wherein the body defines a cavity and at least one opening communicatingwith the cavity; and an elongate shaft and a handle operably coupled tothe elongate shaft, wherein the end effector is operably coupled to theelongate shaft, and wherein the at least one cutting member opening ispositioned between the handle and the cutting surface; wherein thecutting member is configured to translate between a retracted positionand a fully advanced position with respect to the first jaw, wherein theat least one cutting member opening is positioned between the first jawand the handle when the cutting member is at the fully advancedposition.
 11. A surgical instrument, comprising: an end effector,comprising: a first jaw and a second jaw; and an energy deliverysurface; and a closure member, comprising: a camming surface configuredto move the first jaw and the second iaw between an open configurationand a closed configuration; a cutting surface; and heat dissipationmeans for supplying fluid to tissue intermediate the first jaw and thesecond jaw and for dissipating heat from at least a portion of the endeffector.
 12. The surgical instrument of claim 11, further comprising ahandle and an elongate shaft operably coupling the handle to the endeffector, wherein the heat dissipation means comprises a gas containeroperably coupled to the handle, wherein the gas container is configuredto selectively release a gas such that the gas moves through theelongate shaft and to at least a portion of the end effector.
 13. Thesurgical instrument of claim 11, further comprising a handle and anelongate shaft operably coupling the handle to the end effector, whereinthe heat dissipation means comprises a vortex tube operably coupled tothe handle, wherein the vortex tube is configured to expel a cooled gassuch that the gas moves through the elongate shaft and to at least aportion of the end effector.
 14. The surgical instrument of claim 11,further comprising an additional energy delivery surface.
 15. A surgicalinstrument, comprising: an end effector, comprising: a first jaw; and asecond jaw operably coupled to the first jaw; and a movable closuremember, comprising: a camminq surface configured to move the first iawand the second jaw between an open configuration and a closedconfiguration; and a cutting member, comprising: a distal end comprisinga cutting surface; and an intermediate portion proximal to the distalend, wherein the intermediate portion comprises an outer surface,wherein a cavity is defined in the intermediate portion, and wherein atleast one opening extends from the cavity to the outer surface of theintermediate portion.
 16. The surgical instrument of claim 15, furthercomprising an electrode.
 17. The surgical instrument of claim 15,wherein the first jaw further comprises a first energy delivery surface,and wherein the second jaw further comprises a second energy deliverysurface.
 18. A surgical instrument, comprising: an end effectorcomprising a pair of jaws; and a closure beam configured to moverelative to the pair of jaws, wherein the closure beam comprises: a camsurface configured to move the pair of jaws a predefined distance apart;and a cutting member, comprising: a body comprising an outer surface,wherein a cavity is defined in the body, and wherein at least oneopening extends from the cavity to the outer surface; and a distal endcomprising a cutting surface.
 19. The surgical instrument of claim 18,wherein the cutting member defines a longitudinal axis and wherein theat least one opening defines a plane that is parallel to thelongitudinal axis.
 20. The surgical instrument of claim 18, wherein thecutting member defines a longitudinal axis and wherein the at least oneopening defines a plane that intersects the longitudinal axis.
 21. Thesurgical instrument of claim 18, wherein the body comprises a first sideand a second side, wherein the at least one opening comprises a firstopening and a second opening, wherein the first opening extends from thecavity to the outer surface on the first side of the body, and whereinthe second opening extends from the cavity to the outer surface on thesecond side of the body.
 22. The surgical instrument of claim 18,further comprising: a shaft coupled to the end effector; and a handlecoupled to the shaft, wherein the handle comprises a fluid source, andwherein the fluid source is in fluid communication with the cavity. 23.The surgical instrument of claim 18, further comprising an electrode.